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Sunday, March 19, 2017

Teens and Mental Health

Why treating teen mental health is so important

Young people with serious mental health problems are not just going to ‘grow out of it’ – these are big issues that need our attention

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It would be easy to say the stupidest choice I made as a teenager was to start smoking – a compulsive habit that I knew would damage my body and, while offering temporary solutions would, in time, create more problems for the smooth functioning of daily life than it solved. Teaching myself to inhale cigarettes was certainly a stupid decision (I remain addicted) but, as bad decisions go, it was eclipsed a year later when I started putting my cigarettes out on myself.

Self-harm took a grip of my life rapidly in my late teens and into my early 20s and became the most vicious cycle I’ve ever entered. I injured my arms and legs in various ways, in secret. A strong memory of my student summers was sweltering in the long sleeves I was forced to wear. Somehow I didn’t think people would buy the excuse I’d just decided to have go at voguing in a thicket of barbed wire. By my 21st birthday I’d sought help, but didn’t trust myself with anything but an electric razor in my room for shaving.

Self-harming behaviour is often, bizarrely, a survival strategy. It is, in essence, like being in a violent, abusive relationship with yourself – sometimes people use it to punish, other times it feels like a way of expressing the inexpressible. I also remember how the physical pain could abruptly break the absolute terror of emotional paralysis. The truth is that it can feel good to feel something. Even if that something only lasts for about three minutes.

I knew I couldn’t stop it before that exam; I needed it to cope with that party; it would be easier to “sort it out” once term was over – the deadline for addressing it just kept on rolling. Harming isn’t the only behaviour that young people rely on in times of anxiety or depression: sometimes it’s binge eating, sometimes it’s denying themselves food, or alcohol and drug misuse. Years and Years lead singer Olly Alexander, an artist distinguished by his frankness regarding mental health, spoke this week about his own issues around body image and eating, which he says started as early as 10. Alongside this is the data published by CentreForum this week suggests that one in four teens approaching doctors for support are not receiving it.

The system is all too variable. Later in my 20s, I learned some of its tricks – I learned, frankly, to always say I was at risk of self-harm to the GPs receptionist the moment I called them – if you don’t you don’t get an appointment. As a student, I realised I needed to bank up free counselling sessions through my college during term time as during holidays I was reliant on an NHS with a seven month waiting list. It’s particularly terrible that young, inexperienced people who are often struggling to manage their own lives, are forced to calculate and connive against a medical bureaucracy in which it is very easy to flounder for years untreated.

In contrast to this complete crisis for young people and their mental health there seems to be a growing climate of media mockery of their attempts to cultivate their own ways to negotiate mental health issues and trauma. A prime example came from Stephen Fry, who said, “you can’t read Macbeth because it’s got children being killed in it, it might trigger something when you were young that upset you once, because uncle touched you in a nasty place, well I’m sorry. It’s a great shame and we’re all very sorry that your uncle touched you in that nasty place – you get some of my sympathy – but your self-pity gets none of my sympathy because self-pity is the ugliest emotion in humanity.”

It’s a pretty interesting line from the president of Mind, the UK’s leading mental health charity, to turn a culture in which young survivors of assault are clearly left without sufficient support, on the survivors themselves, mocking them for attempts to create better and more conscious ways of respecting mental health issues. I say “attempts” because I wouldn’t say all of these methods are always effective – in some contexts they may even seem excessive – but they are surely better than rhetorical scorn levied by someone in public life who postures as a mental health advocate. My self-harm was not triggered by studying Macbeth for my degree, but I did find myself in a student environment where it generally never entered anyone’s mind – teachers, friends, doctors – that I was cutting myself twice a week. Yet I was – and I’m sure I wasn’t alone.

Whether it’s an eating disorder or self-injury or addiction, destructive behaviours are frequently the symptom of mental health disorders. They arise from a fundamental chasm between inside and outside: they are a desperate bid to exteriorise what seems like an unspeakable pain.

The biggest tragedy is that we know what works for many types of depression: often a combination of talking therapy and monitored medication. Proper, tailored use of these services over time can arrest problems that will otherwise escalate. The tragedy is that our government refuses to afford them the grace of being properly funded, staffed and accessible. The tragedy is that eminent media voices spend so long mocking ‘safe spaces’ instead of speaking to the people who feel they need them. In young people, this is emphasised with that most patronising of admonishments: “grow up!” – as if mental illness is an affectation, like being a deluxe goth.

People with untreated mental health issues do not grow out of it: they die, become homeless, become addicts. I tried to stoically “grow up” by not talking about my depression when I was a teenager – I’d be “grown up” all day then put a hot iron down on my arm instead. It’s only when we divorce the idea of psychological illness from maturity that we have any chance of freeing ourselves from this growing epidemic among British youth.